SUMMARY: Tonsilloliths look and smell gross. And occasionally, they can grow to a huge size.

Posted: December 23, 2011

No one wants tonsilloliths. These little oral objects are perfect for a gross-out contest, because they grow in an odd place and smell truly awful. Nearly everyone who still has their tonsils will get a tonsil stone at some point, but only in rare cases will these little specks grow to an incredible size.

The typical tonsillolith starts as few bits of food. As you swallow, these particles pushes past your tonsils, which are to either side of the back of your throat. Tonsils often have wrinkles or folds in them, which are perfect for scooping up gunk as it passes down your gullet and into your stomach.

Once your tonsils have picked up a few bits of food, oral bacteria go to work on the stuff, digesting it and giving off the compounds that give you bad breath. These microbes form a living slick on the surface of the food - a layer that scientists call a "biofilm," according to a study published in the journal Otolaryngology - Head and Neck Surgery (OHNS).

This film is sticky. Over time it will catch more food, which breeds more bacteria, which catches more food... You get the picture. By gargling with a specialty breath freshening mouthwash, most people with tonsilloliths can pop them out after just a few rinses.

However, left alone for decades, a particularly dug-in tonsil stone could theoretically grow enormously. Studies have recorded some big ones:

- A study appearing in the Journal of Oral and Maxillofacial Surgery recounted a patient who had almost a dozen tonsil stones, some of which were one-quarter of an inch in diameter.

- Another paper, this one in OHNS, described a 51-year-old Taiwanese woman with a one-inch-wide tonsillolith lodged deep in her throat.

- Finally, a report in the Indian Journal of Otolaryngology and Head and Neck Surgery described a 24-year-old woman who was admitted to a hospital with a tonsillolith 1.2 inches across, which may be the largest one ever recorded.